Provider Demographics
NPI:1013053974
Name:ELYADERANI, MORTEZA KADKHODAI (MD)
Entity type:Individual
Prefix:DR
First Name:MORTEZA
Middle Name:KADKHODAI
Last Name:ELYADERANI
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:300 S WALNUT LN
Mailing Address - Street 2:SUITE 100
Mailing Address - City:BEAVER
Mailing Address - State:PA
Mailing Address - Zip Code:15009-1739
Mailing Address - Country:US
Mailing Address - Phone:724-728-6284
Mailing Address - Fax:724-728-7416
Practice Address - Street 1:2500 HOSPITAL DR
Practice Address - Street 2:
Practice Address - City:ALIQUIPPA
Practice Address - State:PA
Practice Address - Zip Code:15001-2123
Practice Address - Country:US
Practice Address - Phone:724-857-1252
Practice Address - Fax:724-857-1254
Is Sole Proprietor?:No
Enumeration Date:2007-01-29
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
PAMD038281E2085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology